Usefulness of a routine endoscopic assessment of laryngeal lesions after lung cancer surgery
| Autor: | Alejandro Witte Pfister, G. Merlusca, Alex Fourdrain, Patrick Bagan, Sophie Lafitte, Pascal Berna, Florence De Dominicis, Jules Iquille |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung cancer surgery Cord medicine.diagnostic_test business.industry Mortality rate medicine.medical_treatment 030204 cardiovascular system & hematology medicine.disease Gastroenterology Surgery Laryngectomy 03 medical and health sciences Pneumonia 0302 clinical medicine 030228 respiratory system Bronchoscopy Cardiothoracic surgery Internal medicine medicine Vocal cord paralysis business |
| Zdroj: | Respirology. 23:107-110 |
| ISSN: | 1323-7799 |
| DOI: | 10.1111/resp.13139 |
| Popis: | Background and objective Laryngeal pathology following lung cancer surgery is associated with post-operative morbidity and mortality. The aim of our study was to evaluate the usefulness of routine endoscopic assessment. Methods We prospectively evaluated vocal cord pathology using laryngeal endoscopy within 24 h post-surgery. Over 25 months, 276 patients underwent thoracic surgery. We excluded 26 patients with previous laryngectomy or vocal cord paralysis, early post-operative reintubation or patients who did not consent to an endoscopy. Endoscopic data were reported using a standardized procedure, recording vocal cord paralysis, swallowing disorders with aspiration, detected using a blue-coloured water test and vocal cord haematoma. Results Among 250 patients, vocal cord paralysis was diagnosed in 13 patients (5.2%) and was associated with a higher rate of post-operative pneumonia (P = 0.03), post-operative bronchoscopy (P = 0.01), reintubation (P = 0.007) and a trend towards an increased 90-day mortality rate (P = 0.09). Swallowing disorders with aspiration were diagnosed in 18 patients (7.2%) and were associated with a higher rate of post-operative pneumonia (P = 0.007), post-operative bronchoscopy (P = 0.01), reintubation (P = 0.004) and 90-day mortality (P = 0.03). Vocal cord haematomas were diagnosed in 28 patients (11.2%) and were not associated with an increased post-operative morbidity or mortality. Conclusion Post-operative endoscopic laryngeal assessment is effective for diagnosing laryngeal pathology following thoracic surgery. Routine laryngeal endoscopic assessment may detect clinically silent swallowing disorders early to allow prompt treatment, which may prevent respiratory complications. |
| Databáze: | OpenAIRE |
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